-张磊-望京医院(0001).pdf

Notice:1.Please follow the below“Sample”template to prepare your case2.The total 25mins case discussion will be allocated as follow:-5 mins to present the patient history&case background with clinical evidences;-Please prepare at least 2 questions with options during the presentation,there will be 1 mins for the audience to vote from the options you set up for each discussion and there will be 5 mins for discussion with all the participants;total 1015 mins for this part.-The 5 mins summary&comments will be provided by the session moderator.3.Please complete all the information required in the“Sample”template4.Please provide all the case information in English5.Please provide 2 cases for the moderator to select for the session Thank you for your great efforts,see you in Mitek B.A.T this OCT!注意事项:1.请根据以下的“案例”模板来准备您的病例2.每个病例讨论25分钟，时间分配如下 5分钟描述病史以及背景，注意要有临床证据 设定至少两个问题，并且分别设计35个选项给到观众投票，每次投票时间1分钟，5分钟所有人参与讨论，此部分共计1015分钟 5分钟主持人做总结以及评价3.请务必遵循以下病例模板完成所有的信息4.要求英文PPT5.请9月15日前提供两个病例供大会主席团选择其一谢谢您的关注和参与，10月份MITEK BAT不见不散！复发性肩关节不稳1例中国中医科学院望京医院张磊 教授重庆 2018 27岁,男性,右力手 初次脱位:患肢外展90时遭遇由前向后暴力.2年间内反复脱位达12次 现在睡觉时压迫患肩即可诱发肩关节脱位 既往史:（）手术史:（）病史 恐惧征(+),前抽屉试验(+),沟槽征(-)肩袖肌力:5 活动度正常 无关节松弛查体查体X rayCT scan比率=0.24骨缺损占比=22%MRIMRI诊断 复发性肩关节不稳 Bony Bankart 损伤您的选择是:1.Bony Bankart 修复?2.骨性阻挡?3.Laterjet?10S内请做出选择治疗选择我们的选择:关节镜下 Laterjet手术术后即刻 CT术后3个月复查CT scan讨论“Critical”Bone Loss“20%-25%”Itoi:21%loss compromised stability in a Bankart repairBurkhart&De Beer（2000）：25%=67%recurrence rate following Bankart repairBoileau et al:25%=75%recurrence rate following Bankart repair“.bone loss above 13.5%led to a clinically significant decrease in WOSI scores consistent with an unacceptable outcome,even in patients who did not sustain a recurrence of their instability”本病例骨缺损(+骨块)=17%谢谢！